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BMC Public Health

Social disadvantage linked to bone and joint disease progression

Unfavorable social conditions were linked to a 21% higher relative risk of a first bone or joint disease than favorable conditions.

Paper by Xiaofeng Ma, Xin Song, Yanqiu Zou, +11 more authorsBen Zhang · Sichuan University
Fig. 1. The flowchart (A) of participants selection and transition patterns (B) from baseline to FDBJD, then to DBJM, and ultimately to death.
Open the figure at full size
Fig. 1. The flowchart (A) of participants selection and transition patterns (B) from baseline to FDBJD, then to DBJM, and ultimately to death.The flowchart (A) of participants selection and transition patterns (B) from baseline to FDBJD, then to DBJM, and ultimately to death.Ma et al.

Our read

Populations
Studied:
Cohort study of 283,146 UK Biobank participants, median 13.7 years (Multicenter)
What changed:
Risk of progression to multiple bone and joint diseases was 33% higher with unfavorable versus favorable social conditions
The catch:
Hospital records could miss milder bone and joint diseases managed outside hospitals
In the record:
The 43rd paper on social determinants of health with results in people; 68 on record in all. Its result on mortality agrees with all 12 other findings on record.
Why it’s aging research:
Biological age, frailty, function, multimorbidity or death.

Editor of record: Boris Djordjevic · AgingResearch.News

Paper
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The 283,146 UK Biobank participants in this prospective observational study averaged 54.9 years old; 52.2% were women. They began without osteoarthritis, a joint disease; osteoporosis, which weakens bones; or spinal disc degeneration. Researchers scored 17 measures of economic circumstances, education, healthcare, neighborhoods and social connections.

Over a median 13.7 years, 43,172 developed one of these conditions, and 4,170 subsequently developed at least two. Unfavorable social conditions were linked to higher risks of disease onset, progression to multiple conditions and death, compared with favorable conditions. Economic stability and social circumstances showed the most consistent links. Among 229,595 participants with complete lifestyle data, statistical models suggested lifestyle partly accounted for the associations. People with both unfavorable social conditions and unfavorable lifestyles had the highest risks.

Why it matters

For age-related bone and joint diseases, the authors called for addressing social conditions alongside lifestyle to reduce disease burden and health inequalities.

Caveats

Unmeasured health differences between social groups could have contributed to the associations. Diagnoses came from hospital records, and the findings do not cover people who already had one of the three conditions at enrollment.

Where the evidence stands

Economic stability

Humans: a single group. Cells, worms or flies and mice: nothing yet.

C, W, M, H: cells, worms or flies, mice, humans. Dark: independent labs found the same change there. Light: one lab or one study. Outline: nothing yet.

Company ties: findings with an author at a company, or from a paper whose competing-interests statement declares ties to one.

  • 1 lab in 1 country
  • Funders: Alzheimer's Association and others
  • 2 of 2 findings with company ties

From the paper

Participants

As shown in Table 1, this study included 283,146 participants with a mean age of 54.9 years (SD = 8.0), of whom 52.2% were female.

Descriptive results

Follow-up

During a median follow-up of 13.7 years, 43,172 participants developed FDBJD, of whom, 4,170 subsequently developed DBJM, and 18,831 died.

Results

Result

… including from baseline to FDBJD (HR = 1.21, 95%CI = 1.18–1.24), from baseline to death (1.58 [1.52–1.65]), from FDBJD to DBJM (1.33 [1.23–1.44]), from FDBJD to death (1.64 [1.50–1.80]), and from DBJM to death (1.48 [1.17–1.87]).

Results

Quoted word for word from the full text on link.springer.com.

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